| NPI | 1932413895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH rn372910) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL rn9286493) |
| 163W00000X Registered Nurse (Licence: TN rn0000172719) | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2010-08-03 |